Targeted Selection of Stimulation Parameters for Restoration of Motor and Autonomic Function in Individuals With Spinal Cord Injury

Claudia Angeli; Enrico Rejc; Maxwell Boakye; April Herrity; Samineh Mesbah; Charles Hubscher; Gail Forrest; Susan Harkema

doi:10.1016/j.neurom.2023.03.014

Targeted Selection of Stimulation Parameters for Restoration of Motor and Autonomic Function in Individuals With Spinal Cord Injury

Neuromodulation. 2023 May 4:S1094-7159(23)00148-4. doi: 10.1016/j.neurom.2023.03.014. Online ahead of print.

Authors

Claudia Angeli¹, Enrico Rejc², Maxwell Boakye², April Herrity³, Samineh Mesbah⁴, Charles Hubscher⁵, Gail Forrest⁶, Susan Harkema⁷

Affiliations

¹ Department of Bioengineering, University of Louisville, Louisville, KY, USA; Kentucky Spinal Cord Injury Center, University of Louisville, Louisville, KY, USA; Frazier Rehabilitation Institute, University of Louisville Health, Louisville, KY, USA. Electronic address: claudia.angeli@louisville.edu.
² Kentucky Spinal Cord Injury Center, University of Louisville, Louisville, KY, USA; Department of Neurological Surgery, University of Louisville, Louisville, KY, USA.
³ Kentucky Spinal Cord Injury Center, University of Louisville, Louisville, KY, USA; Department of Neurological Surgery, University of Louisville, Louisville, KY, USA; Department of Physiology, University of Louisville, Louisville, KY, USA.
⁴ Kentucky Spinal Cord Injury Center, University of Louisville, Louisville, KY, USA.
⁵ Kentucky Spinal Cord Injury Center, University of Louisville, Louisville, KY, USA; Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, KY, USA.
⁶ Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA.
⁷ Kentucky Spinal Cord Injury Center, University of Louisville, Louisville, KY, USA; Frazier Rehabilitation Institute, University of Louisville Health, Louisville, KY, USA; Department of Neurological Surgery, University of Louisville, Louisville, KY, USA.

PMID: 37140522
PMCID: PMC10624649 (available on 2024-11-04)
DOI: 10.1016/j.neurom.2023.03.014

Abstract

Study design: This is a report of methods and tools for selection of task and individual configurations targeted for voluntary movement, standing, stepping, blood pressure stabilization, and facilitation of bladder storage and emptying using tonic-interleaved excitation of the lumbosacral spinal cord.

Objectives: This study aimed to present strategies used for selection of stimulation parameters for various motor and autonomic functions.

Conclusions: Tonic-interleaved functionally focused neuromodulation targets a myriad of consequences from spinal cord injury with surgical implantation of the epidural electrode at a single location. This approach indicates the sophistication of the human spinal cord circuitry and its important role in the regulation of motor and autonomic functions in humans.

Keywords: Epidural stimulation; neuromodulation; rehabilitation; spinal cord injury.

Abstract

Grants and funding